A case report and video presentation on a 9-year-old boy who underwent PAPVC

Maniram1, T. Joseph2 and team

1Consultant – Pediatric Cardiologist, Kauvery Hospital, Heart City, Trichy

2Consultant Interventional Cardiologist, Kauvery Hospital, Heart City, Trichy

Case Presentation

A 9-year-old boy who underwent surgical repair of PAPVC (right upper pulmonary vein) 6 months back. There was mild PV stenosis evident from the first post-op echocardiogram

We obtained a CT angiogram but decided to wait as the child was asymptomatic and only one small vein was affected. He developed one episode of hemoptysis. This was minimal and not very important. However, the PV stenosis could potentially be causative. Therefore, we decided to intervene in the stenosed vein.

The challenges were perforating a pericardial patch which is thicker than the native septum and cannulating the RUPV which is the most difficult to cannulate through a trans septal puncture. We used RF for the puncture and used the 2-wire technique to ensure we would not lose trans septal access while cannulating the vein.

There was a significant decrease in the gradient as well as PA pressure post procedure.

 

Dr. Maniram

Dr. Mani Ram
Consultant – Pediatric Cardiologist

Dr Joseph T

Dr. T. Joseph
Consultant Interventional Cardiologist

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